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coronary microvascular dysfunction

Vahagn Ohanyan, Hamayak Sisakian, Punita Peketi, Ankur Parikh, William M Chilian
No abstract text is available yet for this article.
March 16, 2018: American Journal of Physiology. Heart and Circulatory Physiology
Basmah Safdar, Gail D'Onofrio, James Dziura, Raymond R Russell, Caitlin Johnson, Albert J Sinusas
AIMS: Coronary microvascular dysfunction (CMD) is common in patients with non-obstructive coronary arteries but has not been described in low-risk symptomatic patients. We therefore assessed the prevalence and characteristics of CMD in low to moderate risk patients with chest pain in an emergency department. METHODS AND RESULTS: We used three-dimensional Rb82 cardiac positron emission tomography/computed tomography to diagnose coronary artery disease (known or new regional defect, any coronary calcification) and CMD (low coronary flow reserve without coronary artery disease) in chest pain patients after being ruled out for acute myocardial infarction...
March 1, 2018: European Heart Journal. Acute Cardiovascular Care
Daniel Shpilsky, Sebhat Erqou, Sanjay R Patel, Kevin E Kip, Oluremi Ajala, Aryan Aiyer, Patrick J Strollo, Steven E Reis, Oladipupo Olafiranye
Studies have reported an association between obstructive sleep apnea (OSA) and cardiovascular disease (CVD) morbidity and mortality. Proposed mechanisms include endothelial dysfunction and atherosclerosis. We aimed to investigate the associations of OSA with endothelial dysfunction and subclinical atherosclerotic coronary artery disease (CAD), and assess the impact of race on these associations. We used data from the Heart Strategies Concentrating on Risk Evaluation (Heart SCORE) study, a community-based prospective cohort with approximately equal representation of black and white participants...
March 1, 2018: Vascular Medicine
William E Moody, Matthias Schmitt, Parthiban Arumugam
No abstract text is available yet for this article.
March 7, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Minglin Pan, Ying Han, Aninda Basu, Anzhi Dai, Rui Si, Conor Willson, Angela Balistrieri, Brian T Scott, Ayako Makino
Coronary microvascular rarefaction due to endothelial cell (EC) dysfunction is one of the causes of increased morbidity and mortality in diabetes. Coronary ECs in diabetes are more apoptotic due partly to mitochondrial calcium overload. This study was designed to investigate the role of hexokinase 2 (HK2, an endogenous inhibitor of voltage-dependent anion channel) in coronary endothelial dysfunction in type 2 diabetes. We used mouse coronary ECs (MCECs) isolated from type 2 diabetic mice and human coronary ECs (HCECs) from type 2 diabetic patients to examine protein levels and mitochondrial functions...
March 7, 2018: American Journal of Physiology. Cell Physiology
Niti R Aggarwal, Rachel M Bond, Jennifer H Mieres
Substantial advances and insights in medical technology and treatment strategies, and the focus on sex-specific research have contributed to a reduction in cardiovascular mortality in women. Despite these advances, ischemic heart disease (IHD) remains the leading cause of cardiovascular morbidity and mortality of women in the Western world. Advances in cardiovascular imaging, over the past 4 decades, have significantly improved the evaluation and management of the full spectrum of coronary atherosclerosis, which contributes to ischemic heart disease...
March 5, 2018: Clinical Cardiology
Christine Pacheco Claudio, Odayme Quesada, Carl J Pepine, C Noel Bairey Merz
The syndromes of myocardial infarction/myocardial ischemia with No Obstructive Coronary Artery Disease (MINOCA/INOCA) are increasingly evident. A majority of these patients have coronary microvascular dysfunction. These patients have elevated risk for a cardiovascular event (including acute coronary syndrome, myocardial infarction, stroke, and repeated cardiovascular procedures) and appear to be at higher risk for development of heart failure with preserved ejection fraction. Terminology such as coronary artery disease or coronary heart disease is often synonymous with obstructive atherosclerosis in the clinician's mind, leaving one at a loss to recognize or explain the phenomenon of MINOCA and INOCA with elevated risk...
March 2, 2018: Clinical Cardiology
Alexander Liu, Rohan S Wijesurendra, Joanna M Liu, John C Forfar, Keith M Channon, Michael Jerosch-Herold, Stefan K Piechnik, Stefan Neubauer, Rajesh K Kharbanda, Vanessa M Ferreira
BACKGROUND: In patients with angina and nonobstructive coronary artery disease (NOCAD), confirming symptoms due to coronary microvascular dysfunction (CMD) remains challenging. Cardiac magnetic resonance (CMR) assesses myocardial perfusion with high spatial resolution and is widely used for diagnosing obstructive coronary artery disease (CAD). OBJECTIVES: The goal of this study was to validate CMR for diagnosing microvascular angina in patients with NOCAD, compared with patients with obstructive CAD and correlated to the index of microcirculatory resistance (IMR) during invasive coronary angiography...
March 6, 2018: Journal of the American College of Cardiology
Alexander Liu, Rohan S Wijesurendra, Joanna M Liu, Andreas Greiser, Michael Jerosch-Herold, John C Forfar, Keith M Channon, Stefan K Piechnik, Stefan Neubauer, Rajesh K Kharbanda, Vanessa M Ferreira
BACKGROUND: Novel cardiac magnetic resonance (CMR) stress T1 mapping can detect ischemia and myocardial blood volume changes without contrast agents and may be a more comprehensive ischemia biomarker than myocardial blood flow. OBJECTIVES: This study describes the performance of the first prospective validation of stress T1 mapping against invasive coronary measurements for detecting obstructive epicardial coronary artery disease (CAD), defined by fractional flow reserve (FFR <0...
March 6, 2018: Journal of the American College of Cardiology
Gian Luca Erre, Matteo Piga, Anna Laura Fedele, Silvia Mura, Alessandra Piras, Maria Luisa Cadoni, Ignazio Cangemi, Martina Dessi, Gabriele Di Sante, Barbara Tolusso, Elisa Gremese, Alberto Cauli, Arduino Aleksander Mangoni, Pier Sergio Saba, Ciriaco Carru, Gianfranco Ferraccioli, Alessandro Mathieu, Giuseppe Passiu
Objectives: To define the prevalence and determinants of peripheral microvascular endothelial dysfunction (ED) in a large series of rheumatoid arthritis (RA) patients free of previous cardiovascular events. Materials and Methods: Data from 874 RA patients enrolled in the EDRA study (Endothelial Dysfunction Evaluation for Coronary Heart Disease Risk Estimation in Rheumatoid NCT02341066) were analyzed. Log-transformed reactive hyperemia index (Ln-RHI) was evaluated by peripheral arterial tonometry (PAT) using the EndoPAT2000 device: values of Ln-RHI < 0...
2018: Mediators of Inflammation
Leslee J Shaw, Rory Hachamovitch, James K Min, Marcelo Di Carli, Jennifer H Mieres, Lawrence Phillips, Ron Blankstein, Andrew Einstein, Viviany R Taqueti, Robert Hendel, Daniel S Berman
In this review, we highlight the need for innovation and creativity to reinvent the field of nuclear cardiology. Revolutionary ideas brought forth today are needed to create greater value in patient care and highlight the need for more contemporary evidence supporting the use of nuclear cardiology practices. We put forth discussions on the need for disruptive innovation in imaging-guided care that places the imager as a central force in care coordination. Value-based nuclear cardiology is defined as care that is both efficient and effective...
February 21, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Lazaro E Hernandez
BACKGROUND: Microvascular dysfunction in hypertrophic cardiomyopathy has been associated with poor clinical outcome. Several studies have demonstrated a reduced perfusion reserve proportional to the magnitude of the hypertrophy. We investigated the utility of stress perfusion cardiac MRI to detect microvascular dysfunction in children with hypertrophic cardiomyopathy. METHODS: From January 2016 to January 2017, 13 patients, with a mean age of 15.3 years, with hypertrophic cardiomyopathy underwent regadenoson stress perfusion cardiac MRI (1...
February 22, 2018: Cardiology in the Young
Viola Vaccarino, Samaah Sullivan, Muhammad Hammadah, Kobina Wilmot, Ibhar Al Mheid, Ronnie Ramadan, Lisa Elon, Pratik M Pimple, Ernest V Garcia, Jonathon Nye, Amit J Shah, Ayman Alkhoder, Oleksiy Levantsevych, Hawkins Gay, Malik Obideen, Minxuan Huang, Tené T Lewis, J Douglas Bremner, Arshed A Quyyumi, Paolo Raggi
BACKGROUND: Mental stress-induced myocardial ischemia (MSIMI) is frequent in patients with coronary artery disease and is associated with worse prognosis. Young women with a previous myocardial infarction (MI), a group with unexplained higher mortality than men of comparable age, have shown elevated rates of MSIMI, but the mechanisms are unknown. METHODS: We studied 306 patients (150 women and 156 men) ≤61 years of age who were hospitalized for MI in the previous 8 months and 112 community controls (58 women and 54 men) frequency matched for sex and age to the patients with MI...
February 20, 2018: Circulation
Guanghong Jia, Michael A Hill, James R Sowers
Heart failure and related morbidity and mortality are increasing at an alarming rate, in large part, because of increases in aging, obesity, and diabetes mellitus. The clinical outcomes associated with heart failure are considerably worse for patients with diabetes mellitus than for those without diabetes mellitus. In people with diabetes mellitus, the presence of myocardial dysfunction in the absence of overt clinical coronary artery disease, valvular disease, and other conventional cardiovascular risk factors, such as hypertension and dyslipidemia, has led to the descriptive terminology, diabetic cardiomyopathy...
February 16, 2018: Circulation Research
Min Jae Cha, Sung Mok Kim, Hyun Su Kim, Yiseul Kim, Yeon Hyeon Choe
Background Myocardial perfusion reserve index (MPRI) and extracellular volume fraction (ECV) on cardiac magnetic resonance (CMR) are known to quantify coronary microvascular dysfunction and myocardial fibrosis, respectively. Purpose To demonstrate that cardiovascular risk factors such as hypertension, diabetes, hyperlipidemia, and smoking are correlated with MPRI and ECV on CMR in asymptomatic individuals. Material and Methods Between October 2013 and July 2014, 196 individuals underwent CMR. After excluding those with chest pain, arrhythmia, and obstructive coronary artery disease, participants were divided into five groups: those without risk factor (n = 26) and those with one (n = 43), two (n = 35), three (n = 24), or four (n = 6) risk factors...
January 1, 2018: Acta Radiologica
O Sorop, I Heinonen, M van Kranenburg, J van de Wouw, V J de Beer, T N Nguyen, Y Octavia, R W B van Duin, K Stam, R J van Geuns, P A Wielopolski, G P Krestin, A H van den Meiracker, R Verjans, M van Bilsen, A H J Danser, W J Paulus, C Cheng, W A Linke, J A Joles, M C Verhaar, J van der Velden, D Merkus, D J Duncker
Rationale: More than 50% of patients with heart failure have preserved ejection fraction characterized by diastolic dysfunction. The prevalance of diastolic dysfunction is higher in females and associates with multiple comorbidities such as hypertension (HT), obesity, hypercholesterolemia (HC) and diabetes mellitus (DM), although its pathophysiology remains incompletely understood. It has been proposed that the co-morbidities induce systemic inflammation, cardiac microvascular dysfunction and oxidative stress, leading to myocardial fibrosis, myocyte stiffening and ultimately, diastolic dysfunction...
February 8, 2018: Cardiovascular Research
Gerd Heusch, Andreas Skyschally, Petra Kleinbongard
Plaque erosion, fissuring or rupture occurs spontaneously or during coronary interventions. At some residual blood flow, the atherothrombotic debris is washed into the coronary microcirculation, causing physical obstruction, vasoconstriction, inflammation and ultimately microinfarction. Coronary microembolization also contributes to microvascular obstruction in reperfused acute myocardial infarction. Patients with microvascular obstruction after reperfused myocardial infarction have worse prognosis. Cardioprotective strategies to avoid acute coronary microembolization and rescue myocardium from microvascular obstruction have not yet been established in clinical practice...
February 3, 2018: International Journal of Cardiology
Kathryn Dryer, Mark Gajjar, Nikhil Narang, Margaret Lee, Jonathan Paul, Atman P Shah, Sandeep Nathan, Javed Butler, Charles J Davidson, William F Fearon, Sanjiv J Shah, John Edward Abellera Blair
BACKGROUND: There are multiple proposed mechanisms for the pathophysiology of heart failure (HF) with preserved ejection fraction (HFpEF). We hypothesize that coronary microvascular dysfunction is common in these patients. METHODS AND RESULTS: In a prospective, observational study, patients undergoing cardiac catheterization with HFpEF (left ventricular (LV) ejection fraction {greater than or equal to} 50% and with clinical HF), were compared to similar patients without HFpEF...
February 9, 2018: American Journal of Physiology. Heart and Circulatory Physiology
Richard A Brown, Gregory Y H Lip, Chetan Varma, Eduard Shantsila
INTRODUCTION: Monocyte-platelet aggregates (MPAs) form when Mon1, Mon2 or Mon3 monocyte subsets adhere to platelets. They are pathophysiologically linked to coronary artery disease (CAD). However, their individual roles in the occurrence of diffuse CAD remain unknown. METHODS: Peripheral blood from 50 patients with diffuse CAD, 40 patients with focal CAD and 50 age-matched patients with normal coronary arteries was analysed by flow cytometry to quantify MPAs associated with individual monocyte subsets...
February 9, 2018: European Journal of Clinical Investigation
Philip Brainin, Daria Frestad, Eva Prescott
AIMS: Coronary vascular dysfunction is linked with poor cardiovascular prognosis in patients without obstructive coronary artery disease (CAD) but a critical appraisal of the literature is lacking. METHODS AND RESULTS: We performed a systematic review and meta-analysis to quantify the cardiovascular risk associated with endothelial dependent and non-endothelial dependent coronary vascular dysfunction in patients with normal or non-obstructive CAD (epicardial stenosis <50%)...
March 1, 2018: International Journal of Cardiology
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